Mental Health Bites

Is obesity an Eating Disorder?

We are often told that obesity has reached epidemic levels in the UK, with approximately 27% of adults and 33% of children falling into this category.  Obesity tends to be considered a result of a simple lack of exercise and unhealthy eating habits.  I have written before about how those individuals are treated as making ‘poor choices’, but is it more than this; is obesity an Eating Disorder?

The simple answer to this question has to be yes, sometimes it is.  I can’t stress enough that the vast majority of people with Eating Disorders are not underweight and Anorexia Nervosa is the least common (though most spoken about) of them all.  Fundamentally, Eating Disorders are a coping mechanism – they are emotional distress, lack of self worth, self destruction and anxiety-fuelled collections of behaviours.  For many this takes the form of binge eating or comfort eating.  Many of the people I have, and do, work with, are medically ‘overweight’.

To someone involved in this field it is glaringly obvious than at least some of the UK’s obese individuals have Eating Disorders; that they are eating to meet an emotional need.  So, of course, why would a diet and exercise plan work if the problem is of mental health and ability to cope emotionally?

Our response to this ‘obesity epidemic’ is very reductionist.  Sure, education and meal plans might help some people to lose weight, just as it might help an underweight person to gain weight.  But if the need is EMOTIONAL, the treatment must include this element and understanding as well…otherwise we are setting people up to fail.

Weight

You cannot weigh someone’s Eating Disorder or mental distress with a scale.

The frustrating fact is many of the NHS Eating Disorder services work solely with underweight individuals, further perpetuating the belief that Anorexia Nervosa is ‘the worst’ Eating Disorder.  Well, I can assure you I have seen Binge Eating Disorder destroy physical and mental wellbeing to just the same extent.

All of this means that I was not at all surprised when the February edition of the International Journal of Eating Disorders published research which found that over a quarter of children and adolescents who are overweight or obese showed signs of an Eating Disorder.

Perhaps this is the start of a more honest public perception of what constitutes an Eating Disorder?  For the sake of those struggling, I certainly hope so.

2 thoughts on “Is obesity an Eating Disorder?

  1. Becky

    I agree ? I don’t think weight should be used as the main indicator of disordered eating. Just as some people who are underweight will not have an ED, those who are overweight can have ED needing treatment too.

    I believe the focus should move away from the physical consequences and towards the emotional and psychological drivers behind behaviour.

    Perhaps ED services need to be structured differently to manage patients requiring different interventions, as a service designed for anorexia won’t be adequate at meeting the needs of someone with binge eating disorder but the criteria for accessing support needs to be changed, and at least for services currently offering weight management to include counselling or know when and where to sign post to more psychological support.

    1. Kel Post author

      I very much agree ED services need looking at in order to better work for a more varied client group. Forever a frustration.

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